Provider Demographics
NPI:1750267233
Name:HAIRE, SPENCER
Entity type:Individual
Prefix:
First Name:SPENCER
Middle Name:
Last Name:HAIRE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12746 NW 173RD LN
Mailing Address - Street 2:
Mailing Address - City:ALACHUA
Mailing Address - State:FL
Mailing Address - Zip Code:32615-4468
Mailing Address - Country:US
Mailing Address - Phone:352-538-6559
Mailing Address - Fax:
Practice Address - Street 1:16939 SW 134TH AVE
Practice Address - Street 2:
Practice Address - City:ARCHER
Practice Address - State:FL
Practice Address - Zip Code:32618-5413
Practice Address - Country:US
Practice Address - Phone:352-265-2550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-12
Last Update Date:2025-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program